Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.22 / $345.10 / $9,806.32	Facility		$178.22	$345.10	$9,806.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $178.22 / $237.62	Professional		$173.03	$178.22	$237.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $216.29 / $320.11 / $385.86	Facility		$216.29	$320.11	$385.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $173.03 / $233.59	Professional		$173.03	$173.03	$233.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $172.55 / $241.57 / $317.14	Facility		$172.55	$241.57	$317.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $172.55 / $173.03 / $401.16	Professional		$172.55	$173.03	$401.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.03 / $242.32 / $443.29	Facility		$173.03	$242.32	$443.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $210.05 / $295.83	Professional		$173.03	$210.05	$295.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $106.94 / $173.03 / $249.51	Facility		$106.94	$173.03	$249.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $58.26 / $346.06 / $346.06	Professional		$58.26	$346.06	$346.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $119.07 / $172.55 / $248.82	Facility		$119.07	$172.55	$248.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $172.55 / $192.08 / $2,975.90	Professional		$172.55	$192.08	$2,975.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $106.94 / $173.03 / $249.51	Facility		$106.94	$173.03	$249.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $58.26 / $346.06 / $346.06	Professional		$58.26	$346.06	$346.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $219.45 / $512.00	Professional		$173.03	$219.45	$512.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $173.03 / $173.03 / $824.60	Facility		$173.03	$173.03	$824.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $304.83 / $2,975.90	Professional		$173.03	$304.83	$2,975.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $143.38 / $242.93 / $242.93	Professional		$143.38	$242.93	$242.93
United Facility/Professional Facility Modifier Low / Median / High Price $217.40 / $217.40 / $217.40	Facility		$217.40	$217.40	$217.40
United Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $178.24 / $217.40	Professional		$173.03	$178.24	$217.40